Zusammenfassung
Eine dauerhafte Besserung der schweren Herzinsuffizienz ist mit medikamentösen Maßnahmen und chirurgischen Eingriffen wie Bypassoperationen oder Aneurysmektomie bzw. Klappenersatz nicht zu erzielen. Vor dem Hintergrund dieser schlechten Prognose sind die Erfolge der Herztransplantation in den letzten Jahren zu sehen. Neben der verbesserten Prognose ist für die präoperativ schwerstkranken Patienten die nach einer Herztransplantation gesteigerte Lebensqualität von wesentlicher Bedeutung.
Der entscheidende Durchbruch bei der Herztransplantation erfolgte mit der Einführung der Cyclosporin-A-Therapie in der Behandlung der Abstoßungsreaktionen, die neben Infektionen die häufigste Komplikation darstellen. Seit die immunsuppressive Therapie durch Cyclosporin A ergänzt wurde, sind die Einjahres- und Fünfjahresüberlebensraten deutlich angestiegen. Weltweit wurden seit Ende 1967 ca. 4600 Herztransplantationen durchgeführt.
Summary
A permanent improvement in patients with severe cardiac insufficiency cannot be achieved by drug therapy or with surgical measures like bypass operations, aneurysmectomy, or replacement of valves. This poor prognosis must be kept in mind when viewing the successes of heart transplantation in recent years. Besides the improved prognosis, the much better quality of life after heart transplantation is of great importance for the patients, who have been very ill before the operation.
A big step forward in heart transplantation was the introduction of cyclosporin A therapy in the treatment of transplant rejection, which is the most frequent complication next to infections. Since commencement of the administration of cyclosporin A to complete the immunosuppressive therapy, the 1 year and 5 year survival rates have increased significantly. About 4600 heart transplantations have been performed worldwide since the end of 1967.
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© 1989 Springer-Verlag Berlin Heidelberg
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Theisen, K. (1989). Therapie der terminalen Herzinsuffizienz — Möglichkeiten und Probleme der Herztransplantation aus internistischer Sicht. In: Klose, G. (eds) Arteriosklerose. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-74518-8_10
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DOI: https://doi.org/10.1007/978-3-642-74518-8_10
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